White Kate L, Yates David
School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK.
RSPCA Greater Manchester Animal Hospital, 411 Eccles New Road, Salford, UK.
Vet Anaesth Analg. 2017 Sep;44(5):1027-1034. doi: 10.1016/j.vaa.2016.12.057. Epub 2017 Mar 6.
To compare the clinical effects of alfaxalone, ketamine and propofol in dogs following premedication with medetomidine and methadone.
Prospective, 'blinded' and randomized clinical study.
A total of 75 male dogs presented for neutering at a charity clinic.
Dogs were allocated to be administered alfaxalone, ketamine or propofol following premedication with medetomidine (20 μg kg) and methadone (0.2 mg kg). Dogs were temperament scored prior to premedication. Quality of sedation, induction of anaesthesia, recovery and recovery environment were scored by simple descriptive scales. Physiological variables during anaesthesia were recorded. Continuous numerical data were analysed using analysis of variance with repeated measures as necessary. Nonparametric data were analysed using Kruskal-Wallis tests and multiple comparisons using Dunn's test. Statistical significance was set at p < 0.05.
The mean (± standard deviation) dose of alfaxalone was 0.6 ± 0.2 mg kg, that for ketamine was 1.5 ± 0.7 mg kg and that for propofol was 0.8 ± 0.3 mg kg. Alfaxalone inductions were significantly smoother compared to ketamine but not to propofol. Only one of 75 of the inductions was deemed poor. There were no differences in cardiopulmonary variables between groups except immediately after induction of anaesthesia. There were no differences in quality of recovery between groups.
All three induction agents provided reliable, predictable anaesthesia conditions that were clinically indistinguishable and ideal for teaching anaesthesia skills. The medetomidine and methadone premedication resulted in profound, heavy sedation and the quality of induction of anaesthesia was better with alfaxalone compared to ketamine. No significant difference in induction quality was detected between alfaxalone and proprofol or propofol and ketamine, and these findings are likely to be of limited clinical significance when choosing an induction agent.
比较在使用美托咪定和美沙酮进行预处理后,阿法沙龙、氯胺酮和丙泊酚对犬的临床效果。
前瞻性、“盲法”随机临床研究。
共有75只雄性犬在一家慈善诊所接受去势手术。
犬在使用美托咪定(20μg/kg)和美沙酮(0.2mg/kg)进行预处理后,被分配接受阿法沙龙、氯胺酮或丙泊酚给药。在预处理前对犬的性情进行评分。通过简单的描述性量表对镇静质量、麻醉诱导、苏醒及苏醒环境进行评分。记录麻醉期间的生理变量。连续数值数据在必要时使用重复测量方差分析进行分析。非参数数据使用Kruskal-Wallis检验进行分析,并使用Dunn检验进行多重比较。设定统计学显著性为p<0.05。
阿法沙龙的平均(±标准差)剂量为0.6±0.2mg/kg,氯胺酮为1.5±0.7mg/kg,丙泊酚为0.8±0.3mg/kg。与氯胺酮相比,阿法沙龙诱导明显更平稳,但与丙泊酚相比无差异。75次诱导中只有1次被认为效果不佳。除麻醉诱导后即刻外,各组间心肺变量无差异。各组间苏醒质量无差异。
所有三种诱导药物均提供了可靠、可预测的麻醉条件,临床上难以区分,是教学麻醉技能的理想选择。美托咪定和美沙酮预处理导致深度、重度镇静,与氯胺酮相比,阿法沙龙的麻醉诱导质量更好。阿法沙龙与丙泊酚或丙泊酚与氯胺酮之间在诱导质量上未检测到显著差异,这些发现可能在选择诱导药物时临床意义有限。